VA Doctors Suffer From Electronic Information Overload

By Bob Brewin

March 5, 2013

Veterans Affairs Department doctors are suffering from information overload due to the large number of alerts generated by the department’s electronic health record system, five clinicians reported Monday.

The Computerized Patient Record System module of VA’s Veterans Health Information Systems and Technology Architecture automatically alerts doctors to “abnormal” lab test results and also manually sends them abnormal radiology results. But nearly 30 percent of doctors in a recent survey conducted by Dr. Hardeep Singh of the Houston VA hospital and his colleagues reported missing those alerts.

Singh’s team surveyed 2,590 VA primary care practitioners -- 18 percent of the 14,000 doctors who work for the VA -- from June 2010 through November 2010. The median number of daily alerts the surveyed clinicians reported receiving was 63, and 86.9 percent perceived the quantity of alerts they received to be excessive, the doctors said in a research letter published in JAMA Internal Medicine. Out of that total, 69.6 percent reported receiving more alerts than they could effectively manage, Singh and his colleagues said.

More than half the practitioners surveyed said that the way CPRS is structured made it possible for messages to slip through the cracks, and the 29.8 percent who missed the alerts said this led to delays in care.

If clinicians viewed the VA electronic health record system as easy to use, then they would be less likely to feel they were potentially missing results and delaying care, the research letter said.

Singh and his co-authors suggested further research on why clinicians might be missing information.